Papers

Serum complex of trypsin 2 and (alpha)(sub 1) antitrypsin as diagnostic and prognostic marker of acute pancreatitis: clinical study in consecutive patients

^a Department of Clinical Chemistry and Second Department of Surgery, Helsinki University Central Hospital, FIN 00290 Helsinki, Finland, ^b Department of Surgery, Helsinki University Central Hospital

Correspondence to: Dr U-H Stenman, Department of Clinical Chemistry.

Abstract

Objective: To estimate the usefulness of serum concentrations of the complex of trypsin 2 and (alpha)1 antitrypsin in diagnosing and assessing the severity of acute pancreatitis in comparison with serum C reactive protein, amylase, and trypsinogen 2 concentrations (reference markers).
Design: Markers were measured in consecutive patients admitted with acute abdominal pain that was either due to pancreatitis or to other disease unrelated to the pancreas (controls).
Setting: Department of surgery of a teaching hospital in Helsinki.
Subjects: 110 patients with acute pancreatitis and 66 with acute abdominal diseases of extrapancreatic origin. On the basis of the clinical course, acute pancreatitis was classified as mild (82 patients) or severe (28 patients).
Main outcome measures: Clinical diagnosis of acute pancreatitis and severity of the disease.
Results: At admission all patients with acute pancreatitis had clearly raised concentrations of trypsin 2-(alpha)1 antitrypsin complex (32 µg/l), whereas only three of the controls had such values. Of the markers studied, trypsin 2-(alpha)1 antitrypsin complex had the largest area under the receiver operating curve, both in differentiating acute pancreatitis from extrapancreatic disease and in differentiating mild from severe disease.
Conclusions: Of the markers studied, trypsin 2-(alpha)1 antitrypsin complex was the most accurate in differentiating between acute pancreatitis and extrapancreatic disease and in predicting a severe course for acute pancreatitis.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Pancreatitis may occur with a normal amylase concentration in hypertriglyceridaemia

Pankaj Sharma, Sharon Lim, David James, Robin T Orchard, Morag Horne, and Carl A Seymour
BMJ 1996 313: 1265. [Extract] [Full Text]

This article has been cited by other articles:

• Robin, J., Kharbanda, R., Mclean, P., Campbell, R., Vallance, P. (2003). Protease-Activated Receptor 2-Mediated Vasodilatation in Humans In Vivo: Role of Nitric Oxide and Prostanoids. Circulation 107: 954-959 [Abstract] [Full text]  
• Muller, C A, Appelros, S, Uhl, W, Buchler, M W, Borgstrom, A (2002). Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases. Gut 51: 229-235 [Abstract] [Full text]  
• Lempinen, M., Kylanpaa-Back, M.-L., Stenman, U.-H., Puolakkainen, P., Haapiainen, R., Finne, P., Korvuo, A., Kemppainen, E. (2001). Predicting the Severity of Acute Pancreatitis by Rapid Measurement of Trypsinogen-2 in Urine. Clin. Chem. 47: 2103-2107 [Abstract] [Full text]  
• FROSSARD, J.-L., HADENGUE, A., PASTOR, C. M. (2001). New Serum Markers for the Detection of Severe Acute Pancreatitis in Humans. Am. J. Respir. Crit. Care Med. 164: 162-170 [Full text]  
• Andersen, J. M., Hedstrom, J., Kemppainen, E., Finne, P., Puolakkainen, P. (2001). The Ratio of Trypsin-2-{{alpha}}1-Antitrypsin to Trypsinogen-1 Discriminates Biliary and Alcohol-induced Acute Pancreatitis. Clin. Chem. 47: 231-236 [Abstract] [Full text]  
• Hedstrom, J., Haglund, C., Kemppainen, E., Leinimaa, M., Leinonen, J., Stenman, U.-H. (1999). Time-resolved Immunofluorometric Assay of Trypsin-1 Complexed with {alpha}1-Antitrypsin in Serum: Increased Immunoreactivity in Patients with Biliary Tract Cancer. Clin. Chem. 45: 1768-1773 [Abstract] [Full text]  
• Stenman, U.-H. (1999). New Ultrasensitive Assays Facilitate Studies on the Role of Human Glandular Kallikrein (hK2) as a Marker for Prostatic Disease. Clin. Chem. 45: 753-754 [Full text]  
• BORGSTROM, A, OHLSSON, K, KEMPPAINEN, E, HEDSTROM, J, STENMAN, U-H (1998). Do trypsin 2-alpha -1-antitrypsin complexes occur naturally in the circulation? • Reply. Gut 43: 861-862 [Full text]  
• NEOPTOLEMOS, J P, RARATY, M, FINCH, M, SUTTON, R (1998). Acute pancreatitis: the substantial human and financial costs. Gut 42: 886-891 [Abstract] [Full text]  
• BUCHLER, M W, UHL, W, ANDREN-SANDBERG, A (1998). CAPAP in acute pancreatitis: just another marker or real progress?. Gut 42: 8-9 [Full text]  
• Kemppainen, E, Hedstrom, J, Puolakkainen, P, Halttunen, J, Sainio, V, Haapiainen, R, Kivilaakso, E, Stenman, U-H (1997). Increased serum trypsinogen 2 and trypsin 2-alpha 1 antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy. Gut 41: 690-695 [Abstract] [Full text]  
• Kemppainen, E. A., Hedstrom, J. I., Puolakkainen, P. A., Sainio, V. S., Haapiainen, R. K., Perhoniemi, V., Osman, S., Kivilaakso, E. O., Stenman, U.-H. (1997). Rapid Measurement of Urinary Trypsinogen-2 as a Screening Test for Acute Pancreatitis. NEJM 336: 1788-1793 [Abstract] [Full text]  
• Sharma, P., Lim, S., James, D., Orchard, R. T, Horne, M., Seymour, C. A (1996). Pancreatitis may occur with a normal amylase concentration in hypertriglyceridaemia. BMJ 313: 1265-1265 [Full text]